178AkhilchandraElogcases

  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan A  56 yr old male patient came with complaints of -  Bilateral pedal edema since 20 days C/o shortness of breath since 15 days C/o decreased urine output  - since 15days Pt was apparently asymptotic 3 months 

  78 year old male with farmer by occupation, resident of Annaram came with chief complaints of SOB on exertion, pedal edema and generalised weakness since 20 days HOPI - Pt was apparently asymptomatic 3 months back, then developed SOB which gradually progressed from grade 2 to 3.  This was associated with pedal edema and not associated with chest pain or palpitations.  Orthopnea (+)ve, PND (+) Not h/o facial puffiness, no decreased urine output, no burning micturition H/o fever on and off since 2 months Past history - Pt was diagnosed with dengue 1 month prior K/c/o DM since 10 years, on T. Zoryl-m2 po/bd K/C/O serizure disorder, on T. Carbamazepine 200mg po/od Not k/c/o HTN, CAD, asthma, CVA, TB No h/o blood loss, past surgeries, hemorrhoids, hemoptysis, hematuria or Malena Personal history Sleep adequate, appetite decreased, bowel movements irregular, bladder regular, occasional alcoholic, non smoker General examination O/e- pt is c/c/c AFEBRILE BP- 150/80mmgHg Pr- 81 BPM Rr-24cpm S